What causes osteoporosis?
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Risk factors for developing osteoporosis include:
Steroids – Steroids, which are used to treat a number of inflammatory conditions, can affect the production of bone by reducing the amount of calcium absorbed from the gut and increasing calcium loss through your kidneys. If you're likely to need steroid treatment for more than 3 months your doctor will probably suggest calcium and vitamin D tablets, and sometimes other medications, to help prevent osteoporosis.
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Lack of oestrogen in the body – If you've had an early menopause (before the age of 45) or a hysterectomy where one or both ovaries have been removed, this increases your risk of developing osteoporosis. Removal of the ovaries only (ovariectomy or oophorectomy) is quite rare but is also linked with an increased risk.
Lack of weight-bearing exercise – Exercise encourages bone development. If you don't exercise, or have an illness or disability that makes exercising difficult, you'll be more at risk of losing calcium from the bones and to develop osteoporosis. Muscle and bone health are linked so it's also important to keep up your muscle strength, which will also reduce your risk of falling.
However, women who exercise so much that their periods stop are also at a higher risk because their oestrogen levels will be reduced.
Poor diet – If your diet doesn’t include enough calcium or vitamin D, or if you're very underweight, you'll be at greater risk of osteoporosis.
Heavy smoking – Tobacco is directly toxic to bones. In women it lowers the oestrogen level and may cause early menopause. In men, smoking lowers testosterone activity and this can also weaken the bones.
Heavy drinking – Drinking a lot of alcohol reduces the body’s ability to make bone. It also increases the risk of breaking a bone as a result of a fall.
Family history – Osteoporosis runs in families. This is probably because there are inherited factors that affect bone development. If a close relative has suffered a fracture linked to osteoporosis then your own risk of a fracture is likely to be greater than normal. We don’t yet know if a genetic defect causes osteoporosis, although we do know that people with a very rare genetic disorder called osteogenesis imperfecta are more likely to have fractures.
Other factors that may affect your risk include:
low body weight
medical conditions or treatments that affect the absorption of food – for example, if part of your stomach has been removed (gastrectomy) to treat stomach cancer.
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